Which psycho-demographic factors predict a doctor's intention to leave New Zealand general practice?

To assess the predictive ability of various demographic and psychological variables in respect of New Zealand general practitioners' (GPs') intention to leave general practice.

1000 GPs were surveyed. Demographic variables measured were gender, age, life status, income, hours worked, and work arrangements. Psychological variables measured were satisfaction with general practice (measured by a single item), and commitment to general practice (measured by the Meyer and Allen1,2 three-component model questionnaire). Intention to leave general practice was measured at two time intervals: within 6 months and within 5 years.

The response rate was 58%. Twelve percent of GPs indicated an intention to leave general practice within 6 months, and nearly 30% indicated an intention to leave within 5 years. Despite these intentions, the reported level of satisfaction was reasonably high (mean score 3.67/5) as was the level of commitment (overall 72% reported being committed to general practice). While some demographic variables exhibited statistically significant relationships with intended withdrawal from the occupation, their predictive ability was very poor. Satisfaction with and commitment to general practice were both significantly negatively related to intention to leave and had much higher predictive value than demographic variables. The relationship between satisfaction and intention to leave was mediated by commitment.

For those interested in the maintenance of an adequate GP workforce, these results suggest some attention should be paid to commitment. Further work is necessary to establish how commitment develops and is maintained.